United States District Court, E.D. Missouri, Eastern Division
ROBIN J. MASSA, Plaintiff,
ANDREW M. SAUL, Commissioner of Social Security, Defendant.
SHIRLEY PADMORE MENSAH UNITED STATES MAGISTRATE JUDGE
an action under 42 U.S.C. § 405(g) for judicial review
of the final decision of Defendant Andrew M. Saul,
Commissioner of Social Security (the
“Commissioner”) denying the application of
Plaintiff Robin J. Massa (“Plaintiff”) for
Disability Insurance Benefits (“DIB”) under Title
II of the Social Security Act, 42 U.S.C. §§ 401
et seq. (the “Act”). The parties
consented to the jurisdiction of the undersigned magistrate
judge pursuant to 28 U.S.C. § 636(c). (Doc. 8). Because
I find the decision denying benefits was not supported by
substantial evidence, I will reverse the Commissioner's
denial of Plaintiff's application and remand the case for
March 16, 2015, Plaintiff applied for DIB, alleging that she
had been unable to work since March 13, 2015. (Tr. 145-46).
Her date last insured was September 30, 2015. (Tr. 16). Her
application was initially denied. (Tr. 75-78). On August 25,
2015, Plaintiff filed a Request for Hearing by Administrative
Law Judge (ALJ) (Tr. 82-83). On September 13, 2017, the ALJ
issued an unfavorable decision. (Tr. 11-27). On October 2,
2017, Plaintiff filed a Request for Review of Hearing
Decision with the Social Security Administration's
Appeals Council. (Tr. 142). On May 1, 2018, the Appeals
Council denied Plaintiff's request for review. (Tr. 1-3).
The decision of the ALJ stands as the final decision of the
Commissioner of the Social Security Administration.
outset, the Court notes that because Plaintiff's date
last insured was September 30, 2015, she was required to show
that she was disabled prior to that date. See Moore v.
Astrue, 572 F.3d 520, 522 (8th Cir. 2009). Thus, as the
ALJ did, the Court will focus primarily on the facts relevant
to the period between her alleged onset date (March 13, 2015)
and her date last insured (September 30, 2015). Additionally,
because Plaintiff's challenges to the ALJ's decision
focus on her physical impairments rather than her mental
impairments, the Court will focus primarily on the evidence
relevant to her physical impairments.
4, 2015, Plaintiff completed a Function Report in which she
reported that she was unable to stand for more than ten
minutes without back pain; that sitting too long hurt; that
she could not lift things on a regular basis due to rib and
back pain; and that she got shortness of breath walking up
and down stairs or for long distances. (Tr. 199). She
reported that she typically makes a cup of coffee, sits on a
computer for about an hour, watches television, and tries to
do some light housework, such as sweeping or dusting. She
reported waking up several times a night and having
difficulty falling asleep. (Tr. 200). She reported being able
to drive for about an hour at a time. (Tr. 200). She prepared
simple meals daily. (Tr. 201). She reported sweeping floors,
dusting, and doing laundry, though her spouse carried the
laundry up and down the stairs. (Tr. 201). She reported
shopping in stores for groceries. (Tr. 202). She reported
that she can no longer go to yard sales, because getting in
and out of the car often hurts. (Tr. 206). She stated that
she cannot hold her grandchild for longer than ten minutes if
she is sitting down. (Tr. 206). She stated that her back and
rib cage hurt constantly and that pain relievers do not
really help. (Tr. 206). She also stated that due to her
chronic fibromyalgia, she has not been able to do anything
that she used to do; if she does anything extra, she cannot
move very well the following day. (Tr. 206).
April 13, 2017, Plaintiff testified as follows at the hearing
before the ALJ. Plaintiff testified that she gets short of
breath when she does a lot of walking or goes up steps. (Tr.
41). Her lower back hurts all the way down into her left leg.
(Tr. 41). She cannot sit for very long and cannot walk or
stand for very long. (Tr. 41). She also has COPD (Tr. 41).
Plaintiff has also been diagnosed with fibromyalgia, which
causes her shoulders to ache and causes joint pain in her
elbows, knees, and hips. (Tr. 42). Plaintiff has been
depressed for several years and is on medication. (Tr. 41).
Plaintiff testified that she has good days and bad days. (Tr.
42). On a bad day, she gets up, makes a little breakfast, and
sits in her recliner off and on all day long. (Tr. 42). On a
good day, she might go out into the backyard with her dogs or
might drive to the Dollar Store. (Tr. 42). She testified that
she has bad days about three or four days a week, which is an
improvement over when she stopped working and the bad days
were every day. (Tr. 44).
stopped working in March 2015, because she could not do her
job anymore. (Tr. 43). She had trouble carrying and filing
legal briefs, and she had trouble walking up and down the
steps to the basement to get the mail. (Tr. 43). She also
could not sit for very long. (Tr. 43). She also had bouts of
crying fits on the job. (Tr. 43). Her energy level was very
low. (Tr. 44).
daughter also testified at the hearing before the ALJ.
Plaintiff's daughter testified that before Plaintiff
moved in with her, Plaintiff's daughter visited her three
to five times a week to do “typically all of her
housework, ” including laundry, sweeping, cleaning
bathrooms, doing dishes, and yard work. (Tr. 47). Plaintiff
was able to do some of those activities with her daughter,
but it took her a long time because she could only stand for
a little while. (Tr. 48). She seems to be okay if she is
standing or walking for short periods of time, but she could
not, for example, stand at the sink for half an hour to do
dishes. (Tr. 48).
medical records show that in the months leading up to
Plaintiff's alleged disability onset date, Plaintiff
reported pain in her ribs and thoracic spine, for which she
received various medications. (Tr. 249, 253-59, 279-84,
295-301, 322-25, 358-360). In January 2015, she also began
reporting pain in her lumbar spine. (Tr. 279-84). A January
2015 X-ray of the lumbar spine showed normal alignment, no
evident spondylosis, and no osseous abnormality. (Tr. 249).
In February 2015, she also began reporting pain in her
shoulder, neck, knee, hand, elbow, and ankle. (Tr. 295). A
plan was made for physical therapy. (Tr. 301).
her alleged disability onset date, Plaintiff continued to
have back pain, as well as respiratory issues. On March 17,
2015, Plaintiff called her doctor's office with questions
about her medications, stating that she had been in quite a
bit of pain recently. (Tr. 348). On April 27, 2015, Plaintiff
presented to the emergency room with chest pain. (Tr. 376).
On July 28, 2015, an MRI of the thoracic spine performed due
to mid back pain showed no evidence of central canal or
neuroforaminal stenosis throughout the thoracic spine; no
evidence of disc bulge or herniation within the thoracic
region; and “partial visualization of a disc bulge/HNP
at the C5-6 level.” (Tr. 536). On August 20-21, 2015, a
pulse oximetry summary report indicated that Plaintiff
qualified for nocturnal oxygen under Medicare guidelines.
(Tr. 515). On September 2, 2015, Plaintiff was diagnosed with
chronic obstructive lung disease, benign essential
hypertension, anxiety, and abnormal liver function, and
smoking cessation was strongly recommended. (Tr. 400). On
September 8, 2015, a lumbar spine X-ray showed mild
degenerative changes of the lumbar spine (Tr. 644); a lumbar
spine MRI showed degenerative changes of the lumbar spine
resulting in mild spinal canal and mild-to-moderate
neuroforaminal stenoses (Tr. 642-43); and a pelvic X-ray
showed mild degenerative changes of the sacroiliac joints and
the hips (Tr. 640). On September 24, 2015, Plaintiff filled
out a physical therapy questionnaire indicating that pain
medication provided her with little pain relief and that she
had difficulty walking more than a quarter of a mile, sitting
for an hour, or standing for more than a half an hour. (Tr.
548). Her “Oswestry Back Disability Index” showed
a total disability score of 48%, though it was noted that the
score was expected to decline over the course of treatment.
(Tr. 547). A plan was made for physical therapy two to three
times per week for four to six weeks. (Tr. 551). On September
29, 2015, Plaintiff returned to physical therapy, though she
was unable to tolerate some exercises. (Tr. 556-57).
months following Plaintiff's date last insured, she had
steroid injections for lumbar pain (Tr. 678-79), and she went
to the emergency room on several occasions for rib, chest, or
abdominal pain or breathing problems (Tr. 495, 568-69, 575,
583). She also sought treatment for pulmonary issues and
thoracic spine pain. (Tr. 620, 627, 395-98, 504-05).
respect to the other details Plaintiff's medical records
and the other records in the administrative transcript, the
Court adopts the facts as presented in the parties'
respective statements of fact. The Court will cite to